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School Refusal And Avoidance In Youth

School Refusal And Avoidance In Youth

School avoidance, also known as school refusal and school phobia, is defined by Stanford Children’s Hospital as “a term used to describe the signs of anxiety a school-aged child has and his or her refusal to go to school.” It is not listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as it is not recognized as a mental illness. Rather, school refusal is considered a symptom and “may be associated with diagnoses such as social anxiety disorder, generalized anxiety disorder, specific phobias, major depression, oppositional defiant disorder, post-traumatic stress disorder, and adjustment disorder, among others.” Approximately 50% of youth struggle with school refusal criteria for a mental health diagnosis. Certain situational reasons (e.g., bullying, divorce, moving, death of a loved one, difficulty getting along with teachers, lacking close friendships, etc.) could also trigger the onset of school avoidance. School refusal is not uncommon, and data suggests that school avoidance occurs among 2 to 4% of all children, from early childhood through high school. 

Signs and Symptoms 

The primary sign that is exhibited by an adolescent that is school avoidant is the clear refusal to attend school. This can manifest in different ways. Some examples of behaviors exhibited by a young person who is school avoidant include the following, provided by Harvard Medical School:

  • Refusing to get dressed in the morning
  • Purposefully missing the bus to school
  • Constant complaints of different physical ailments
  • Neglecting to do homework
  • Anxiety
  • Weight fluctuation
  • Depression
  • Social isolation

When a teenager goes to a doctor for his or her physical ailments, frequently no illness or medical diagnosis will be found. Most adolescents who experience school avoidance are unable to articulate their discomfort and do not actually know why they feel sick. The symptoms surrounding a teen’s school avoidance, most commonly, will be present on school days and absent on the weekends. When left untreated, youth who engage in school refusal are at increased risk of a variety of negative life outcomes, including academic underachievement, diminished self-confidence, social isolation, friendship difficulties, and poorer physical and mental health.

For Information and Support

Every family in need of mental health treatment must select a program that will best suit the needs of their family. When one member of a family struggles, it impacts everyone in the family unit. To maximize the benefits of treatment we work closely with the entire family to ensure that everyone is receiving the support they need through these difficult times.

Seeking help is never easy, but you are not alone! If you or someone you know needs mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person’s life, in the long term. Pursuing support at the beginning of one’s journey can put the individual in the best position to learn how to manage themselves in a healthy way so they can go on to live happy and fulfilling lives.


We are available to answer any questions you may have regarding mental health treatment and our residential program, anytime. Contact us today using the form to the right.


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